Why All Parents Need to Know About Paced Bottle Feeding

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There are perks to feeding a baby from a bottle, including convenience and allowing other caregivers to bond with the baby during feedings, whether you’re giving a baby expressed milk or formula. 

Bottle feeding may seem pretty straightforward, but you might have some concerns.

If you’re combining nursing and bottle feeding, you might be concerned about your baby experiencing nipple confusion and struggling when going back and forth between the two.

Or perhaps you’re concerned bottles are contributing to gas and reflux, which makes your baby uncomfortable and fussy.

There’s a method of bottle feeding, called paced bottle feeding, which can help with all of these concerns.

Paced bottle feeding is designed to mimic breastfeeding, but it can be used with all babies being fed from a bottle, no matter what’s inside the bottle or how often you offer a bottle. You want to feed your baby the best and in the safest way -  here's a way how. 

We’ll review the philosophy behind paced feeding and how to get started with paced bottle feeding.

What is Paced Bottle Feeding?

Paced bottle feeding is all about slowing down the rate at which a baby eats from a bottle and learning to recognize a baby’s hunger and fullness cues.

This method of bottle feeding lengthens the time a feeding takes by adding frequent pauses in milk flow. This prevents babies from drinking their milk too quickly. 

Paced bottle feeding is accomplished by holding the bottle horizontally so milk flows more slowly through the nipple. 

Babies have to actively suck to receive the milk and are more in control of the feeding pace as opposed to holding a bottle vertically and letting gravity do the work. When using this method make sure to hold the head and neck securely to help prevent choking hazards. The feeding ends when your little one signals they’re full or they fall asleep, whether the bottle is empty or not, but more on that later.

Pace feeding is intended to mimic the natural pattern of breastfeeding. Breastfed babies are in control of how much and for how long they eat at the breast. Babies naturally take breaks in relation to the flow of breastmilk, which ebbs and flows over several letdowns during each feeding.  

Benefits of Paced Bottle Feeding

Whether you’re using bottles to offer breastmilk, formula, or a combination of the two, paced bottle feeding offers the following benefits:

• Helps babies learn to recognize their body’s fullness signals from a young age. When parents and caregivers feed in response to a baby’s cues, they’re less likely to over-or under-feed the baby. 

• Cuts down on gassiness, reflux, and digestive discomfort. Just like you probably feel bloated and gassy after inhaling a meal, a baby's digestive system gets overwhelmed when they eat too quickly or eat too much.

• Supports healthy growth and weight gain since the baby is less likely to be over-or underfed.

• Encourages connection and a responsive feeding relationship between child and caregiver.

• Supports healthy oral development, which is important for speech and advanced feeding skills.

• Supports the breastfeeding relationship and prevents nipple confusion or flow preference for babies who are both breastfed and bottle-fed. 

How to do Paced Bottle Feeding

You can start practicing paced bottle feeding as soon as you introduce a bottle to your baby.

Here are the steps to do paced bottle feeding:

1. Starting with clean hands, prepare a sterilized bottle and nipple.
   
   
2. Get comfortable and hold your baby in an upright position in your arms. Your baby may slightly recline, but should not be laying flat.
   
   
3. Brush the nipple across your baby’s lips and chin to encourage them to open their mouth wide and take the nipple in their mouth.
   
   
4. Hold the bottle horizontally so it’s parallel to the floor. Once the baby begins to suck on the nipple, tilt the bottle slightly to fill the nipple about halfway with milk.
   
   
5. Allow the baby to suck and swallow for about 20 to 30 seconds, keeping the bottle mostly horizontal the entire time, and then offer a break by lowering the bottom of the bottle to stop the flow of milk into the nipple. 
   
   You can either control the pace by pausing after every few swallows or time breaks with your baby’s natural pauses. You don’t need to remove the nipple from the baby’s mouth during a pause. The slow-flow nipple does its job by working milk slowly.
   
   
6. When your baby begins to suck again, tip the bottle so milk fills the nipple halfway again.
   
   
7. Repeat this process until your baby shows signs of fullness. Let your baby take charge in these feeding sessions. Allow them air while feeding and allow your baby to pull away when they are full. Learn their feeding cues and establish a set feeding schedule. 
   
   
8. You can also switch the side you hold the baby on to mimic switching breasts. This can help breastfed babies avoid preferring one side over another and benefits all babies with healthy visual development.

Is Paced Bottle Feeding Only for Breastfed Babies?

Paced bottle-feeding can be used for any baby being fed a bottle. It doesn't matter whether the bottle is being used to feed a baby breastmilk or formula. 

Pace feeding can be used whether babies are exclusively bottle-fed or receive a combination of formula or pumped milk.

This bottle feeding method can be helpful when transitioning breastfed babies to bottles. While there are some benefits of using pace feeding for nursing and pumping mothers, both breastfed and formula-fed babies can benefit from paced bottle feeding. This gives your baby more control in the way they eat and is especially helpful as your baby gets older.

How Do I Know That My Baby Has Had Enough?

Preventing overfeeding, or giving your baby too much milk or formula in feeding, is a core principle and one of the main benefits of paced bottle feeding.

It can be tempting to keep track of how many ounces your baby has eaten, but it’s not the most accurate way to gauge when your baby has had enough to eat. There’s no standard for how much milk or formula a baby should consume at each and every feeding.

In general, most feedings should last 10 to 20 minutes. But keep in mind all babies are different and march to the beat of their own drums.

Your baby’s appetites may fluctuate between feedings, days, weeks, and months. Your baby may eat more or less per feeding depending on how long it’s been since the last time they ate or if they’re experiencing a growth spurt or developmental leap. 

For very young babies, how sleepy they feel often determines how much they can eat at any given time, while older babies with more developed vision may get distracted by their surroundings while eating.

Instead of tracking milk consumption, you can learn to recognize your baby’s fullness cues.

Likewise, you can learn to look for signs that your baby is hungry. This is known as feeding on demand versus following a timed schedule.

Signals that your baby is hungry and is ready to eat include:

• Rooting aka turning their head with mouth open
• Smacking lips
• A bit fussy
• Sucking on fingers and hands

Signals that your baby has had enough to eat include:

• Unclenched hands
• Slowed sucking
• Releases bottle nipple
• Turns head away
• Keeps mouth closed
• Attention turns elsewhere
• Drowsiness or falling asleep

It’s common for babies to doze off during or after a feeding. Falling asleep is a sign that a baby is full, even if they haven’t finished the bottle. The exception is newborns in their first few weeks of life who need to eat frequently and should be woken up to be fed.

Do I Need to Use Any Special Kind of Bottles?

You don’t need any special equipment or a particular type of bottle to start practicing paced bottle feeding, but there are some considerations you may want to think about when selecting bottles.

Some pediatricians and lactation consultants recommend using nipples and/or bottles that are labeled slow-flow. Since paced bottle feeding is all about slowing down how quickly a baby receives milk from a bottle, this type of gear may help.

The ideal bottle for you and your baby is one that’s comfortable for you to hold and that the baby can and will deeply latch onto.

As a reminder, a proper latch is essential for successful feedings, whether you’re breastfeeding or bottle-feeding. Your baby’s mouth should open wide, the nipple should be placed on top of the tongue angled toward the roof of your baby’s mouth, and your baby’s lips should be splayed outward against the wide base of the nipple.

There’s some mixed messaging in what kind of bottle is best for a deep latch. Some pediatric feeding specialists recommend bottles with a narrow-shaped nipple because it may be easier for the baby to properly latch onto. 

Some parents find their babies prefer wider shaped bottles and nipples that more closely resemble the shape of a breast.

As with hunger and fullness cues, it’s best to look to your baby to know which style bottle to use. If your baby seems to consistently latch easier with one style bottle over another, that’s the bottle to start with for paced feeding.

If your baby seems frustrated or distressed during a bottle-feed, the milk flow may be too slow. Likewise, if your baby is sputtering or gagging during a bottle-feed, the milk flow may be too fast. Trying a different bottle with a different flow rate may help.

If you have questions about how to do paced bottle feeding with your baby or you have specific concerns about your baby’s eating patterns, make an appointment to speak with a lactation consultant, pediatric dietitian, or your child’s pediatrician.

The content and advice provided in this article is for informational purposes only and is not a substitute for medical diagnosis, treatment, advice for specific medical conditions. Always consult a pediatrician to understand the individual needs of your child.